Objective  To understand the carriage of extended-spectrum β-lactamase (ESBLs) strains in intestinal tracts of children in an area of Wuxi, and provide reference for the rational use of antibiotics in clinical anti-infection treatment.

  Methods  A total of 131 stool samples of healthy children in child care setting and 107 stool samples of sick children in a hospital in Wuxi were collected in 2018. ESBLs screening medium was used to screen ESBLs-producing strains, strain types were identified and drug susceptibility test was conducted.

  Results  A total of 112 ESBLs-producing bacterial strains were screened, including 57 strains isolated from the healthy children and 55 strains isolated from the sick children. All the strains were Enterobacteriaceae. Escherichia coli isolates accounted for the highest proportion (89.28%). The resistance rates of ESBLs strains detected in the healthy children and the sick children to cephalosporins, i.e. cefazolin, cefuroxime and ceftriaxone, were all above 90%. The differences in resistance to tobramycin (χ²=5.153, P=0.023) and cephalosporin cefuroxime (χ²=4.003, P=0.045) of aminoglycoside were significant (P<0.05). The multidrug resistance rate was as high as 82.12% (92/112). In addition, one carbapenem-resistant E. coli strain which was resistant to ertapenem was detected in the sick children (MIC=2). A multidrug resistant E. coli strain was isolated from one of the healthy child, which was not sensitive to 10 classes of antibiotics.

  Conclusion  The ESBLs-producing Enterobacteriaceae usually exist in intestinal tracts of children in some areas of Wuxi, and the multidrug resistance is serious. Close attention should be paid to the rational use of antibiotics in children.